Should menopause care measure function? Functional Menopause as a testable research framework

Contemporary menopause care increasingly recognises the multidimensional nature of midlife health, but it remains uncertain whether this broader perspective should include longitudinal measurement of functional capacity. We propose Functional Menopause as a testable framework for examining whether assessment of physical, cognitive, sexual, urogenital, and participation-related function provides clinically useful information beyond symptom burden and established risk assessment. Such an approach could identify adverse functional trajectories that are not captured by symptoms or biomarkers, but it could also medicalize normal ageing, misapply geriatric thresholds to midlife women, increase clinical burden, and widen inequities. Before routine implementation, prospective research should establish measurement properties, normative trajectories, prognostic validity, incremental clinical utility, feasibility, and clinical impact. Functional Menopause should therefore remain a research hypothesis rather than a screening recommendation or diagnostic construct.